What is HE?

Hepatic encephalopathy (HE) is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting.1 In patients with cirrhosis and decreased hepatic function, toxins from the gut can enter the bloodstream and reach the brain, where they affect neurotransmission.1-3 This can cause episodes of HE, which may present as alterations in consciousness, cognition, and behavior that range from minimal to severe.1-3

HE is a problem hiding in plain sight

Recognizing patients at risk. The risk of HE is higher in patients with cirrhosis/chronic liver disease and4:

  • Portal hypertension
  • Ascites
  • Variceal bleeding
  • Medications, such as opioids

The risk of HE recurrence is high1,5,6

Once overt HE occurs, patients have a high risk of recurrence1,5,6:

  • Cumulative risk of an overt HE recurrence at 1 year: 40%
  • 40% cumulative risk of another overt HE recurrence within 6 months, despite standard-of-care treatment

HE and overt HE can be a burden for patients and families

  • Overt HE may cause irreversible damage1,7,8
  • HE-related hospitalizations rose 325% from 2005 to 20149*
  • Other costs: disability, lost productivity, stress on caregivers10

*ICD-9-CM codes at hospital discharge: 291.2 (alcohol-induced persisting dementia), 348.3 (encephalopathy, unspecified), and 572.2 (hepatic encephalopathy); all listed diagnoses.

HE = hepatic encephalopathy

AASLD = American Association for the Study of Liver Diseases


XIFAXAN® (rifaximin) 550 mg tablets are indicated for the reduction in risk of overt hepatic encephalopathy (HE) recurrence in adults and for the treatment of irritable bowel syndrome with diarrhea (IBS-D) in adults.

  • XIFAXAN is contraindicated in patients with a hypersensitivity to rifaximin, rifamycin antimicrobial agents, or any of the components in XIFAXAN. Hypersensitivity reactions have included exfoliative dermatitis, angioneurotic edema, and anaphylaxis.
  • Clostridium difficile-associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including XIFAXAN, and may range in severity from mild diarrhea to fatal colitis. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued.